Manual of Genetics Fetal Medicine and Color Doppler SN Tripathy, PK Shah, Prashant Acharya, KC Mahapatra, SK Giri, Chinmayee Ratha, Priti Dubey, Jyotshna Panigrahy, Sonia Pattnaik
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fm1Manual of Genetics, Fetal Medicine and Color Doppler
fm2fm3Manual of Genetics, Fetal Medicine and Color Doppler
Editors SN Tripathy KC Mahapatra SK Giri PK Shah Prashant Acharya Chinmayee Ratha Priti Dubey Jyotshna Panigrahy Sonia Pattnaik
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Manual of Genetics, Fetal Medicine and Color Doppler
First Edition: 2018
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fm5Contributors fm7Message
Rishma Dhillon Pai
MD DNB FCPS DGO FICOG
President, FOGSI—2017
Consultant Gynecologist
Jaslok Hospital, Lilavati Hospital and Hinduja Healthcare (Khar),
Bloom IVF Centre,
The Every Woman Clinic,
Mumbai, Maharashtra, India
“Wisdom.... comes not from age, but from education and learning.”
Anton Chekhov
Life is a continuous process of learning. Especially in the field of medicine, which is constantly changing, it is very important to keep oneself abreast with the latest developments. It is heartening to note that academic workshop manuals are being released at the AICOG, Bhubaneswar, Odisha, India, for the benefit of the participating delegates and present varied updates in the field. Many different Manuals are being released on important subjects such as 3D Laparoscopy and Operative Oncology, Genetics, Fetal Medicine and Color Doppler, Postpartum Hemorrhage and High-Risk Pregnancy, Hysteroscopy, etc.
I thank all the authors, for their immense contributions in building up the content for the manuals for Federation of Obstetric and Gynaecological Societies of India (FOGSI) by sharing their rich experiences in the field. These will be a big help to young gynecologists, who are still acquiring skills in various aspects of obstetrics and gynecology and a quick update for the seniors.
I extend congratulations to the organizing team of the AICOG 2018 and the editors of these manuals and wish you all success for this mega event.
“You cannot open a book without learning something.”
Confucius
fm8Message
Jaideep Malhotra
MD FICMCH FICS FMAS FRCOG FlCOG FRCPI FIAJAGO
Consultant ART (IVF)
President Elect, FOGSI—2018
Director, Rainbow IVF
Agra, Uttar Pradesh, India
“Education is greatest gift of life, it should never stop.”
The subject of obstetrics and gynecology needs extreme proficiency as it deals with the medical specialties that focus on two different aspects. First one includes the care of pregnant women, the unborn baby, labor and delivery, as well as the immediate period following childbirth. Second aspect includes dealing with any ailment concerning the female reproductive organs. Hence, the manuals will help all those who are looking forward to gain excellence in the field of woman health. The manuals have tried to address all the issues a doctor needs.
With increasing expertise in all fields, the surgeon therefore while exercising a choice needs to follow the Hippocratic dictum—“First, do no harm.”
We are thankful to all those who have incorporated their contribution by providing chapters from their research and collected scientific material and have shared their fruitful experiences for the delegates of the workshop.
As a part of my agenda for 2018, I as FOGSI President 2018, plan to work actively on QED (Quality, Ethics and Dignity) among our profession and also work towards HER (Health, Empowerment and Respect) towards our patients.
“Knowledge is of no value unless you put it into practices.”
fm9Message
Hrishikesh Pai
Secretary General, FOGSI
It is my proud privilege to invite and welcome all delegates to the 61st All India Congress of Obstetrics and Gynaecology (AICOG) from 17th–21st January, 2018 at the Temple City of India, Bhubaneswar, Odisha, India.
It is propitious to note that the academic workshop manuals are being released which will reap beneficial reward to all the participating delegates.
I thank all the authors, for their immense contributions in building up the content for the manuals for Federation of Obstetric and Gynaecological Societies of India (FOGSI) by sharing their rich experiences in the field. These will be a big help to young gynecologists, who are still acquiring skills in various aspects of obstetrics and gynecology and a quick update for the seniors.
I forward my heartiest congratulations to all the contributors, the editors and the delegates of the workshop.
fm10Message
PC Mahapatra
Professor Department of Obstetrics and Gynecology
SCB Medical College
Cuttack, Odisha, India
President, FOGSI—2011
Organising Chairperson
It is my proud privilege to invite and welcome all delegates to the 61st All India Congress of Obstetrics and Gynaecology (AICOG) from 17th–21st January, 2018 at the Temple City of India, Bhubaneswar, Odisha, India.
The five days of academic extravaganza will certainly enrich the scientific knowledge of all participating delegates and faculty. The precongress workshop on various aspects of this specialty will be held on 17th January 2018.
A quote by Edwin Louis Cole says that “Winners are not those who never fail but those who never quit” is apt for all the clinicians who are determined enough to see and overcome all the difficulties that are faced in the field of obstetrics and gynecology.
Today, with the advancement in the field of obstetrics and gynecology, everyone requires an in-depth knowledge of the complex subjects associated with the field so as to gain excellence in it.
This manual will prove to be a boon to all those who are associated with the field and wants to gain more knowledge in the subject matter.
fm11Message
HP Pattanaik
Head
Department of Obstetrics and Gynecology
City Hospital
Cuttack, Odisha, India
Vice President, FOGSI—2009
Organising Secretary
Greetings from 61st AICOG 2018!
It is a matter of great pleasure to invite you all to 61st AICOG, from 17th–21st January, 2018 at the Temple City of India, Bhubaneswar, Odisha, India. The 11th Precongress workshops will be held on 17th January, 2018 in three medical colleges of Bhubaneswar.
It is propitious to note that the academic workshop manuals are being released which will reap beneficial reward to all the participating delegates.
It will also prove to be beneficial to the members of Federation of Obstetric and Gynaecological Societies of India (FOGSI), those who were unable to register themselves for the academic workshops.
I forward my heartiest congratulations to all the contributors, the editors and the delegates of the workshop.
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fm13Preface
The desire of knowledge, like the thirst of riches, increases ever with the acquisition of it.
Laurence Sterne
Maternal-fetal medicine began to emerge as a discipline in the 1960s. Advances in research and technology allowed physicians to diagnose and treat fetal complications in utero, whereas previously, obstetricians could only rely on heart rate monitoring and maternal reports of fetal movement. The development of amniocentesis in 1952, fetal blood sampling during labor in the early 1960s, more precise fetal heart monitoring in 1968, and real-time ultrasound in 1971 resulted in early intervention and lower mortality rates.
In 1963, Albert William Liley developed a course of intrauterine transfusions for Rh incompatibility regarded as the first fetal treatment. Other antenatal treatments, such as the administration of glucocorticoids to speed lung maturation in neonates at risk for respiratory distress syndrome, led to greater outcomes for premature infants.
Consequently, organizations were developed to focus on these emerging medical practices, and in 1991, the First International Congress of Perinatal Medicine was held. Today, maternal-fetal medicine specialists can be found in major hospitals internationally.
The field of maternal-fetal medicine is one of the most rapidly evolving fields in medicine especially regarding the fetus. Research is being carried on in the field of fetal gene and stem cell therapy in hope to provide early treatment for genetic disorders, open fetal surgery for the correction of birth defects like congenital heart disease, and the prevention of preeclampsia.
CVS enables early, first trimester prenatal diagnosis and is a suitable alternative to amniocentesis. In addition to being safe it also gives privacy of early diagnosis and making decision. Transabdominal or transcervical CVS is the diagnostic technique of choice in pregnancies of less than 12 weeks of gestation. In experienced hands, there is minimal risk of pregnancy loss.
Fetal arrhythmia is most disconcerting because it is difficult to interpret arrhythmia in absence of fetal ECG and we have to derive information from mechanic events of atria and ventricular. Atrial contraction represents P wave and ventricular contraction represents QRS complex and both should be seen simultaneously. This is achieved by M Mode and Doppler methods.
The use of assisted reproductive technology has contributed significantly to the increase in multifetal pregnancies. When multifetal pregnancies do occur, incorporating an ethical framework will help obstetricians counsel and guide patients as they make decisions regarding continuing or reducing their multifetal pregnancies.fm14
The color Doppler workshop and the Genetic and Fetal Monitor workshop will deal with many such issues and clear your doubts. We are sure that you will go back with recent knowledge about fetal medicine and practice the same. The purpose of this workshop is to make choices cleaner to the delegates, but not make choices for them.
‘He who learns and makes no use of the learning is a beast of burden with a load of books.’
Editors